This article is excerpted from a chapter in "Finding Hope in Despair: Clinical Studies in Infant Mental Health" (edited by Marian Birch, published 2008 by ZERO TO THREE). Therapeutic intervention with children and families is not always successful, but the professional literature does not often address treatment failures. To address this need, "Finding Hope in Despair" explores the limitations of infant-parent psychotherapy by examining treatment failures using a unique format for reflective discussion.